4241 Rahn Rd - Inspection FormCity of Evan
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name r
PID Number
House Number ,, I Street Name
Alternative Mailing Address Phone // ' IT/
17 Fes i
OwnerlOccupant Signature
For information call 651.470.278$
Compliance
No foundation drain connection
No roof drain connection
O Sump pic not connected to
sanitary sewer
{, O Sump pump properly piped
Cp` No sump pump
Service Lateral Inspection Findingt
Roots � t )
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
� i
Transition i r� � -4—
-
4" to 6" Transition:
White Copy: Proper ty Owner
1_411 Time
Disk #
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks 'J
Length of Service:
Record Number
Time
Entered S.L. at
Notes
7
•
Inspector Signature
Obstruction
Unable to push past
feet
• (.. / 0 am
• / pm
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
='7
r_Final Cleanout: ( AL
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
Foundation drains
71)
L__.--/
Roof drains
City of Evan
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name r
PID Number
House Number ,, I Street Name
Alternative Mailing Address Phone // ' IT/
17 Fes i
OwnerlOccupant Signature
For information call 651.470.278$
Compliance
No foundation drain connection
No roof drain connection
O Sump pic not connected to
sanitary sewer
{, O Sump pump properly piped
Cp` No sump pump
Service Lateral Inspection Findingt
Roots � t )
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
� i
Transition i r� � -4—
-
4" to 6" Transition:
White Copy: Proper ty Owner
1_411 Time
Disk #
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks 'J
Length of Service:
Record Number
Time
Entered S.L. at
Notes
7
•
Inspector Signature
Obstruction
Unable to push past
feet
• (.. / 0 am
• / pm
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
='7
r_Final Cleanout: ( AL
Yellow Copy: City of Eagan Pink Copy: SEH